Abstract
BACKGROUND: Polypharmacy and low literacy increase medication self-administration errors (MSEs) among older adults, adversely affecting both patients and healthcare systems through increased costs and reduced treatment efficacy. OBJECTIVES: This study explored the reasons for MSEs among illiterate and low-literate older adults with polypharmacy from the perspective of older adults, informal family caregivers, physicians, and pharmacists. METHOD: The qualitative study used a conventional content analysis approach from September 2022 to April 2023. Purposeful sampling was used to recruit participants for interviews. RESULTS: The study included fifteen older adults, five caregivers, four physicians, and seven pharmacists. Seven main categories were extracted: 1) Age-related physical and cognitive changes, 2) Medication Mismanagement, 3) Inhibitor beliefs of proper medication use, 4) Caregiving challenges, 5) Deficiency in effective communication and education, 6) Health systems inefficiencies, 7) The challenges of producing, dispensing and obtaining medications. CONCLUSION: The origins of MSEs encompass a broad spectrum of factors, ranging from individual to systemic levels. Successful interventions for reducing errors will be those that take into account all aspects of error occurrence and strive to minimize them through a holistic approach. The findings highlight the importance of improving organizational health literacy strategies for older adults with limited literacy. Tailoring health information to the specific needs of older patients is crucial for addressing MSEs.